title: A woman's influence to choose mastectomy as treatment for breast cancer.
abstract: BACKGROUND
  Over a 10-y period at our community hospital, more than 50% of women 40 y of age and younger underwent a mastectomy as first line breast cancer treatment. These results catapulted a study to identify personal and physical implications of a mastectomy and to determine if, in women of all ages, breast conservation therapy with close follow-up is a better alternative to mastectomy.
  
  
  METHODS
  Six hundred eight women underwent a mastectomy for breast cancer from 1989 to 2005 at our teaching institution; 77% (n = 120) of 156 successfully contacted women agreed to participate in the study, and 70% (n = 84) of them completed a questionnaire.
  
  
  RESULTS
  Most women discovered their breast cancer through mammography or self breast examination, 31% and 28%, respectively. Five patients were diagnosed at Stage 0, 35 at Stage 1, 26 at Stage 2, 8 at Stage 3, 1 at Stage 4, and 9 patients had an unknown stage of disease. Sixty-three patients primarily discussed their treatment plan with a surgeon; 80 were satisfied with the time spent discussing their treatment. Twenty-four patients underwent various reconstruction procedures; most (75%) were satisfied with their treatment and reconstruction choices.
  
  
  CONCLUSIONS
  Mastectomy as a treatment choice for breast cancer did not have the negative personal and physical outcome that we had predicted. Personal choice and a surgeon's advice were the primary influencing factors on the women's treatment choice of mastectomy. Adequate preoperative discussion time and a multimodality cancer team can be most helpful in providing comprehensive treatment options for all women with breast cancer.
authors.affiliation: Department of Surgery, Saint Mary's Health System, Waterbury, CT 06706, USA. tfanche@hotmail.com
authors.forename: Tiffany T
authors.initials: TT
authors.lastname: Fancher
authors.forename: J Alexander
authors.initials: JA
authors.lastname: Palesty
authors.forename: Reney
authors.initials: R
authors.lastname: Thomas
authors.forename: Tami
authors.initials: T
authors.lastname: Healy
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Fancher
authors.forename: Chonn
authors.initials: C
authors.lastname: Ng
authors.forename: Stanley J
authors.initials: SJ
authors.lastname: Dudrick
mesh_terms: D000223:Adaptation, Psychological; D001828:Body Image; D001943:Breast Neoplasms / Q000523:psychology / Q000601:surgery*; D003657:Decision Making; D005260:Female; D006801:Humans; D008408:Mastectomy / Q000523:psychology*; D015412:Mastectomy, Segmental / Q000523:psychology; D008875:Middle Aged; D010358:Patient Participation; D017060:Patient Satisfaction; D016387:Women's Health